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“Where will the money come from?” said Adriane Carrier, nurse and union steward at Dignity-owned St. John’s Regional Medical Center in Oxnard. She predicted the financial issues of merger partner Catholic Health Initiatives will be felt in Ventura County and across a Catholic network that would instantly become one of the nation’s largest systems.

“We will, at the bedside, continue to see cutbacks or a slowing of replenishing supplies,” she said.

The merger cleared its last major regulatory hurdle when the California Department of Justice issued conditional approval the day before Thanksgiving. The Vatican gave its OK in October. Dignity leaders said final closure is expected on Dec. 31.

‘We do not expect any jobs to be reduced’

They said employees at St. John’s Regional in Oxnard, St. John’s Pleasant Valley in Camarillo and other hospitals across a merged system named CommonSpirit Health will be provided more information after the deal is closed.

The new system will operate 700 care sites across 21 states including 140 hospitals. Dignity leaders say the merger will bring resources that will improve their ability to provide critical health services and help ensure the future of local hospitals.

In Oxnard and Camarillo, Dignity leaders said, there will be little noticeable change. The St. John’s names will stay. All services currently offered will continue to be offered.

“We do not expect any jobs to be reduced in our California service areas,” said St. John’s CEO Darren Lee in a September public hearing on the merger. “...Funds raised in this community will stay here.”

Union leaders question financial stability of merger

As the pending merger marches closer, some people employed or affiliated with St. John’s wait for more news on local impacts. An area doctor praised the new system as the wave of the future in a tightening market that relies less on in-patient care.

Nursing union leaders question the promises made by system and local leaders.

Gayle Batiste, president of SEIU Local 121RN and an operating room nurse at Dignity-owned Northridge Hospital Medical Center, cited Catholic Health Initiatives financial struggles. The Colorado-based system reported an operating loss of $276.7 million in the fiscal year that ended in June, an improvement over a $593.4 million loss in fiscal 2017.

“We anticipate that this will endanger the future financial outlook of all hospitals in this merger,” Batiste said in a written statement that emphasized the possibility of budget cuts.

“If a hospital is in the red they’re going to cut somewhere,” she said. “Too often the line item that administrators cut first and most is staffing levels, in addition to other dangerous corner-cutting that puts patient safety at risk.”

Carrier said St. John’s in Oxnard is already going through a financial “tightening of the belt,” adding issues range from pharmaceutical delays to needs for new beds and upgraded computers. She worried the merger will exacerbate financial scrambling, specifically citing the reliance on temporary nurses rather than adding permanent, full-time staff RNs.

“It’s not a believable statement,” she said of promises the merger won’t impact local hospitals. “We’re already experiencing changes.”

Carrier and Batiste both expressed angst about the massive scale of the merger.

“The only thing they do is eliminate competition, which is rarely good for either employees or consumers,” wrote Batiste.

St. John’s spokeswoman Megan Maloney said the merger will have no impact on the quality of care and will create a strong financial and operational foundation. Responding to Carrier’s claims, she said St. John’s commitment is reflected by a modernization and expansion project at the Oxnard hospital and a new 50-bed wing expected to open before Christmas at St. John’s Pleasant Valley in Camarillo.

“We recently invested more than $100 million to ensure our facilities continue to provide the best care possible utilizing the most advanced, state-of-the-art technology so that our patients do not have to travel to receive world-class care,” she said.

Carrier contended the travel nurses who work at a hospital temporarily are not always familiar with St. John’s protocol or California regulations. She said they end up taking the money paid to them out of the community.

Maloney said St. John’s uses “some of the best travel nurses in the country,” adding they are utilized to supplement core staff when the hospital is filled with patients.

Dr. David Mescher, an Oxnard physician on staff at St. John’s in Camarillo and Oxnard, said the merger creates economies of scale needed to deal with financial changes in health care. The partnership brings together not just hospitals but networks of different levels of care.

“It’s the type of alignment we know we’re going to see all across the United States,” he said, predicting the trend will bring shrinking hospitals and an evolution of in-home care.

Maloney said employees are being updated on the merger as much as possible, with messages sent out at least weekly. David Aguilar, an care coordinator assistant at St. John’s Pleasant Valley Hospital and former union steward, said the updates are limited.

“There hasn’t been really much talk about the impact on the employees,” he said, suggesting people are waiting to see tangible results — good or bad — before forming opinions.

Conditions set for the merger by the California Department of Justice include mandates for hospitals to maintain emergency services and women’s health care for 10 years. During the last five years of that period, requests to change the services have to be run by the attorney general’s office.

Other mandates are designed to bolster charity care programs at the system’s California’s hospitals and also bring $20 million over six years to a new homeless health initiative.

Leaders of a non-nursing union that represents employees at the two St. John’s hospitals said they anticipate a strong relationship with the new company.

“We fully expect that there will be no reductions in staffing levels, quality of care, Medi-Cal and indigent access and women’s and LGBTQ health services,” SEIU-United Healthcare Workers West leaders said in a written statement, “and are prepared to speak up and take action if the company falls short on these vital issues.”